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Sedona EnerQi Retreat, April 1-5
Sedona EnerQi Retreat Registration Form

We will review your registration form and email you the retreat information package including detail schedule within 24 hours of receipt
First Name: *
Last Name: *
Address Street 1: *
City: *
Zip Code: * (5 digits)
State: *
Daytime Phone:
Evening Phone: *
Email: *
Date Of Birth: *
Emergency Contact -
name and phone number: *
Please list any health
or physical disabilities we should be aware of: *
Please list any dietary
restrictions or food allergies
we should be aware of: *
What is the main thing you want to get from this retreat?
Any travel, tourist, lodging
assistance needed? We can
make suggestions: *
Comments:
  We will contact you personally regarding sleeping arrangements/preferences and to schedule your private session time with Jimmy Allen.

I agree to pay the remaining financial balance in full by 3-12-2010 
Security Code: *  

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Inspirational Learning Academy is a fully supported project of International Humanities Center, a 501[c](3) nonprofit public charity created in 1998 to foster social and ecological justice, as well as efforts in the realm of peace, education, women's and children's issues, and animal rights. Contact ILA

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